Aside from their natural infirmities, old people are not subject to a great many acute discomforts. And this is natural, because if any serious disease does assail them they are liable to succumb to it.
The cause of death among old people is, in 50 per cent of the cases, disease of the circulatory system. Pneumonia accounts for about 10 per cent; cancer and kidney disease 10 per cent apiece. By the time a person has reached 60, he has acquired immunity to nearly all infections, although a few are commoner in old age than in younger years. Among these must be reckoned erysipelas, which is particularly a disease of old age. The slightest accident, such as knocking the shin against a chair, or any abrasion of the skin, is liable to be followed by erysipelas in old people.
In the case of heart disease, it is astounding how long people can live in comfort with extensive heart damage. I have seen hearts removed from the bodies of inhabitants of old people’s homes which – did not have one single blood vessel left to carry nourishment to the heart muscle. They had all been closed by the process of hardening of the arteries. The heart appeared to be nourished entirely from the blood contained within its chambers, which was squeezed out in sinuses in the heart muscle. This is rendered possible, of course, only by the extremely sedentary nature of the life led by those of advanced years.
The management of the heart in senile patients is the primary duty of the attendant. Symptoms of shortness of breath or dropsy should always be remarked. A recent writer on the subject, and one of the most eminent of American physicians, says he still regards digitalis as the most valuable remedy in old age for support of the heart muscle. Another splendid drug for the aged heart is caffeine, either in the form of coffee or caffeine sodium benzoate.
One of the difficulties of treating the heart during these years is that it is dangerous to leave old people in bed too long. No elderly person should stay in bed more than a day at a time, if possible.
Gentle daily general massage is also valuable in the treatment of these patients. The use of water in the form of special baths, and heart exercises which are used for younger people, should not, however, be attempted for obvious reasons.
A good night’s sleep is particularly desirable in these conditions, but to procure it for old people is a matter of great difficulty. The preparations which are used to induce sleep in younger patients do not work satisfactorily with the aged, and many of them induce actual mental disturbances.